Tissue Doppler Imaging for assessment of pseudonormalization of the mitral inflow pattern

Impairment of left ventricular relaxation may lead to pulmonary congestion and symptoms of heart failure even in patients with preserved systolic function. Doppler echocardiography has become the non-invasive method of choice for the assessment of both systolic and diastolic dysfunction. However, Doppler-derived parameters such as mitral inflow velocity, deceleration time and isovolumic relaxation time are affected by age, heart rate and loading conditions. In the setting of an increase in left ventricular and left atrial filling pressures, the trans-mitral pressure gradient rises. As a consequence, pseudonormalization of the mitraI inflow may mask diastolic dysfunction.